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Individual

ADAM GOTTLIEB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
387 OCEAN AVE, MASSAPEQUA PARK, NY 11762-1623
(516) 528-4329
Mailing address
387 OCEAN AVE, MASSAPEQUA PARK, NY 11762-1623

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
309995
NY

Other

Enumeration date
09/29/2020
Last updated
09/29/2020
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